The Comptroller and Auditor General (CAG) in its audit report has detected serious inadequacies in infrastructure facilities at hospitals. Many hospitals have no trauma care and emergency medical services. Shortage of doctors is yet another major crisis faced by the hospitals, the report says. It has also criticized the health department for not finalizing a comprehensive health policy.

It has pointed out that an effective planning process was essential for the health department to marshal its financial and human resources. The audit noticed that no appraisal was conducted by the department to identify the current status of the hospitals. A comprehensive picture at the state level on the availability of the major diagnostic services at the hospitals was not available with the directorate of health service (DHS).

While the department had an annual plan as part of the five-year plan, it did not prescribe methodologies or make a schedule to achieve the standardization norms. On the lines of the national health policy 2002, only a draft health policy was formulated which is yet to be adopted by the state government, the report said.

The development of infrastructure facilities in public health institutions as per standardization norms is essential for providing quality medical services. However a status check on the select hospitals has found several shortcomings.

Out of the 23 taluk headquarters hospitals where status check was conducted, communicable diseases ward, and geriatric and palliative care ward is available only in four and three hospitals respectively. Only three out five district hospitals have communicable diseases ward and none of the district hospitals has geriatric and palliative care ward.

Mortuary facilities were not available in 15 test-checked hospitals. In general hospital a freezer with four compartments is available to preserve four bodies. However on the day of the visit the audit noticed that 11 bodies were preserved against its capacity.

Generators were not available in six out of the 33 test-checked hospitals. The audit noticed that no operations were performed in these hospitals because of non-functional theatres, lack of equipment, absence of surgeons, gynaecologists, etc. The audit noticed crowded out-patient departments with doctors examining patients in candlelight.

Medical equipment constitutes an integral part of diagnostic and treatment procedure in hospitals. The audit noticed that 93 medical items remained unutilized in the 11 test-checked hospitals. ECG, X-ray and ultra sound scanners are essential diagnostic equipment for providing quality medical care to the patients. But the audit noticed that ultra sound scanners were not available in 19 taluk headquarters hospitals.

The more serious inadequacies were detected when it was found that trauma care and emergency medical services were not available in 22 test-checked taluk headquarters, five district hospitals and three general hospitals. The report has criticized the general hospital in for not having a trauma care unit despite a steep increase in the trauma care victims at the hospital.

The audit has pointed out that though the state government had upgraded certain hospitals, necessary additional posts were not created in these hospitals. Against the request of the DHS to accord sanction for 2,514 posts in 2010 to improve the poor services delivered by hospitals, only 1,626 posts of various categories were sanctioned.